THE

BARTHEL
INDEX

Patient Name: _________________________

Rater Name : _________________________
Date
: _________________________

Activity

Score

FEEDING
0 = unable
5 = needs help cutting, spreading butter, etc., or requires modified diet
10 = independent

_______

BATHING
0 = dependent
5 = independent (or in shower)

_______

GROOMING
0 = needs to help
5 = independent face/hair/teeth/shaving (implements provided)

_______

DRESSING
0 = dependent
5 = needs help but can do about half unaided
10 = independent (including buttons, zips, laces, etc)

_______

BOWELS
0 = incontinent (or needs to given enemas)
5 = occasional accident
10 = continent

_______

BLADDER
0 = incontinent, or catherized and unable to manage alone
5 = occasional accident
10 = continent

_______

TOILET USE
0 = dependent
5 = needs some help, but can do something alone
10 = independent (on and off, dressing, wipping)

_______

TRANSFERS (BED TO CHAIR AND BACK)

0 = unable, no sitting balance
5 = major help (one or two people, physical), can sit
10 = minor help (verbal or physical)
15 = independent

_______

MOBILITY (ON LEVEL SURFACES)

0 = immobile or < 50 yards
5 = wheelchair independent, including corners. > 50 yards
10 = walks with help of one person (verbal or physical) > 50 yards
15 = independent (but may use any aid, for example , stick) > 50 yards

_______

STAIRS
0 = unable
5 = needs help (verbal, physical, carrying aid)
10 = independent

_______
TOTAL (0-100) _______